House Speaker Mike Johnson told a group of supporters on Monday night that Republicans will seek “massive reform” to the Affordable Care Act if Donald Trump is reelected — previewing a major piece of the GOP’s legislative plans for next year.
During a campaign swing in Pennsylvania, the GOP speaker vowed that overhauling the 14-year-old health care law would be part of a “very aggressive” first 100-days agenda if Republicans win back control of the White House, according to a video of the event obtained by CNN. Johnson was speaking at a GOP campaign event at Trump’s volunteer headquarters in Bethlehem, Pennsylvania.
At one point, an attendee asked Johnson directly: “No Obamacare?” And the speaker, wearing a personalized Trump-Vance jacket, responded: “No Obamacare.”
Johnson’s comments on the landmark 2010 health care law known as Obamacare — which has been a perennial GOP punching bag — come as both parties are making their closing arguments to voters. Vice President Kamala Harris has repeatedly warned that Trump would seek to dismantle the Affordable Care Act if he regains the White House, while the former president has said he would improve the law.
The speaker’s remarks are particularly notable after the Republican party’s high-profile failure to repeal key parts of the health care law during Trump’s first term in office.
“Health care reform is going to be a big part of the agenda,” Johnson said at the event. It was Johnson’s third time visiting the critical swing seat in the Lehigh Valley in eastern Pennsylvania as he looks to help GOP challenger Ryan Mackenzie unseat Democratic Rep. Susan Wild.
In a statement issued Wednesday, Johnson said he was not, in fact, vowing to repeal the health care law and was instead talking about broader reforms.
“Despite the dishonest characterizations from the Harris campaign, the audio and transcript make clear that I offered no such promise to end Obamacare, and in fact acknowledged that the policy is ‘deeply ingrained’ in our health care system,” Johnson said. “Still, House Republicans will always seek to reduce the costs and improve the quality and availability of health care for all Americans.”
Republican leaders attempted to dismantle Obamacare when they had full control of Washington in 2017, but were stymied by then-Sen. John McCain, who opposed the GOP’s effort because the party didn’t have a substantive plan to replace the law. Since then, Republicans have shifted focus away from health policy, especially as they eye a big tax overhaul early next year.
There’s also the political reality: Republicans in Congress have failed to do much more than chip away at the edges of the law, while the Supreme Court has repeatedly upheld the legislation.
But Johnson made clear this week that the GOP isn’t giving up on targeting the law.
“The ACA is so deeply ingrained; we need massive reform to make this work. And we got a lot of ideas on how to do that,” Johnson said.
The speaker offered no specifics of the GOP’s legislative plans but noted that a group of Republican physicians in the House, known as the GOP Doctors Caucus, has been drafting potential legislative ideas.
And he said it wouldn’t just be health care getting a massive “free market” overhaul.
“We need this across the board. And Trump’s gonna go big. I mean, he’s only gonna have one more term, right?” Johnson said.
House Minority Leader Hakeem Jeffries, the top House Democrat, also seized on the comments in a campaign trek across Michigan.
“Just yesterday, the top Republican in the House said one of the first things they’ll do is repeal and get rid of the Affordable Care Act as we know it. This is still on their mind,” Jeffries said at a union hall in Lansing, Michigan, according to video obtained by CNN. “We know they’ll do it because I’m convinced that if Roe v. Wade can fall, then anything can fall.”
Johnson’s remarks were first reported by NBC News.
Health care in the 2024 campaign
Johnson’s comments are yet another example of the danger a Republican sweep poses to the Affordable Care Act, the Harris campaign contends.
While the once-contentious health care law has not been a major theme of the 2024 campaign, Harris has repeatedly sought to remind Americans of her opponent’s determination to eviscerate Obamacare when he was in office. In particular, she has focused on the potential overhaul of the law’s protections for people with pre-existing conditions, which are among its most popular provisions.
Taking a different tact than his previous campaigns, Trump himself has stressed to voters that he wouldn’t eliminate the health care law. His national press secretary, Karoline Leavitt, reaffirmed that in a statement to CNN on Wednesday, saying, “Repealing Obamacare is not President Trump’s policy position.”
The former president is now positioning himself as a savior of the Affordable Care Act and has promised to further improve it. However, when asked for details in September’s presidential debate, he said he had “concepts of a plan.”
His running mate, Ohio Sen. JD Vance, has offered some insight into the reforms Republicans might seek – telling NBC in September “you also want to implement some deregulatory agenda so that people can choose a health care plan that fits them.”
In particular, he discussed allowing insurers to separate healthy and sick enrollees into different risk pools, which he argued will broaden the options available to consumers, but health care experts say could leave sicker people paying higher premiums.
Vance later backtracked somewhat, saying he supported the Trump administration’s approval of several states’ waiver applications to implement reinsurance programs in their Affordable Care Act exchanges. This generally lowered Obamacare premiums by providing funding for insurers that enrolled many high-cost patients.